Epidemiology and Infection

Original Papers

Hepatitis

Hepatitis B vaccination and changes in sexual risk behaviour among men who have sex with men in Amsterdam

M. XIRIDOUa1 c1, J. WALLINGAa1a2, N. DUKERS-MUIJERSa3 and R. COUTINHOa1a4

a1 National Institute of Public Health and the Environment, Bilthoven, The Netherlands

a2 University Medical Center, Utrecht, The Netherlands

a3 Amsterdam Health Service, Amsterdam, The Netherlands

a4 Academic Medical Centre, University of Amsterdam, The Netherlands

SUMMARY

The impact of hepatitis B vaccination in men having sex with men in Amsterdam has been marginal until now, possibly because of increases in sexual risk behaviour counterbalancing the effect of vaccination. A mathematical model is used to describe the hepatitis B epidemic. The model shows that, with the current vaccination coverage, the decrease in incidence is small in the beginning. However, the number of infections prevented per vaccine administered rises over time. Nevertheless, increased risk behaviour reduces the benefit of vaccination. Targeting high-risk men is more successful in reducing and containing the epidemic than targeting low-risk men. In conclusion, the vaccination campaign is effective and should be intensified. High-risk men should be targeted for vaccination and for risk reduction.

(Accepted June 07 2008)

(Online publication July 17 2008)

Correspondence:

c1 Author for correspondence: Dr M. Xiridou, National Institute of Public Health and the Environment, PO Box 1, 3720 BA Bilthoven, The Netherlands. (Email: maria.xiridou@rivm.nl)

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